OrthoIdaho, Pocatello, Idaho, USA.
Department of Family Medicine, Idaho State University, Pocatello, Idaho, USA.
J Ultrasound Med. 2020 Mar;39(3):441-452. doi: 10.1002/jum.15120. Epub 2019 Aug 26.
The purpose of this study was to determine the safety and efficacy of ultrasound-guided carpal tunnel release (USCTR) in a consecutive group of patients treated by a single primary care sports medicine physician.
The study group consisted of 35 USCTRs performed on 22 consecutive patients for whom clinical outcomes were available before USCTR and at 1 to 2 weeks, 1 month, and 3 months after USCTR. All procedures were performed by the same operator using a single USCTR technique. Outcomes included complications, Quick Disabilities of the Arm, Shoulder, and Hand scores, Boston Carpal Tunnel Questionnaire symptom severity and functional status scores, and a 5-point global satisfaction score.
The 22 patients included 13 female and 9 male patients (ages 31-82 years). Eleven patients (22 wrists) had bilateral simultaneous USCTRs; 2 patients (4 wrists) had staged bilateral USCTRs; and 9 patients had unilateral USCTRs. No complications occurred in any patient. Statistically and clinically significant reductions in Quick Disabilities of the Arm, Shoulder, and Hand scores and Boston Carpal Tunnel Questionnaire symptom severity and functional status scores occurred by 1 to 2 weeks after USCTR (mean 1- to 2-week changes, -29.23, -1.74, and -1.18, respectively), and further improvements occurred during the 3-month follow-up period (mean 3-month changes, -51.11, -2.29, and -1.91; P < .0001 for all values versus before USCTR). Mean global satisfaction scores at 1 to 2 weeks and 3 months were 4.63 and 4.66.
Ultrasound-guided CTR is a safe and effective procedure that can be performed by an experienced primary care sports medicine physician and typically results in significant improvements within the first 2 weeks after the procedure. Furthermore, bilateral simultaneous USCTRs are feasible and may provide significant advantages for patients who are candidates for bilateral CTRs.
本研究旨在确定由一位初级保健运动医学医师连续治疗的患者中，超声引导腕管松解术（USCTR）的安全性和有效性。
研究组由 22 名连续患者的 35 例 USCTR 组成，这些患者在 USCTR 之前和之后 1 至 2 周、1 个月和 3 个月时均具有临床结果。所有程序均由同一位操作员使用单一的 USCTR 技术进行。结果包括并发症、Quick 上肢功能障碍问卷（Disabilities of the Arm, Shoulder, and Hand，DASH）评分、波士顿腕管问卷（Boston Carpal Tunnel Questionnaire，BCTQ）症状严重程度和功能状态评分以及 5 分制总体满意度评分。
22 名患者包括 13 名女性和 9 名男性（年龄 31-82 岁）。11 名患者（22 个手腕）双侧同时行 USCTR；2 名患者（4 个手腕）分期双侧 USCTR；9 名患者行单侧 USCTR。任何患者均未发生并发症。在 USCTR 后 1 至 2 周，Quick DASH 评分和 BCTQ 症状严重程度和功能状态评分均显著降低（平均 1 至 2 周变化分别为-29.23、-1.74 和-1.18），并且在 3 个月的随访期间进一步改善（平均 3 个月变化分别为-51.11、-2.29 和-1.91；所有值与 USCTR 前相比，P 均<.0001）。1 至 2 周和 3 个月时的平均总体满意度评分为 4.63 和 4.66。
超声引导 CTR 是一种安全有效的手术，可以由经验丰富的初级保健运动医学医师进行，通常在手术后的前 2 周内即可获得显著改善。此外，双侧同时 USCTR 是可行的，并且对于适合双侧 CTR 的患者可能具有显著优势。
